肾移植后糖尿病:可改变与不可改变的危险因素

Variable and invariable risk factors for diabetes mellitus after kidney transplantation

背景:肾移植后糖尿病是肾移植的主要并发症,了解其发生的危险因素并进行预防,可提高肾移植患者的存活率。目的:探讨肾移植后糖尿病发生的高危因素。方法:应用文献检索的方法获取肾移植后糖尿病发生危险因素的相关研究文献,对符合研究标准的文献进行深入的数据分析。对进行肾移植的患者进行空腹血糖、餐后2 h血糖、糖化血红蛋白以及肝功能、免疫抑制剂浓度谷值等各项指标的检测观察,分析肾移植后糖尿病的发生是否与患者性别、年龄、体质量指数、糖尿病家族史、肾移植后糖尿病起病时间、肝功能以及免疫抑制剂和激素的应用等因素有关。结果与结论:研究结果显示,肾移植后糖尿病患者的症状不典型,起病早,胰岛功能受损,肝功能异常。肾移植患者的年龄、体质量指数、糖尿病家族史、糖耐量异常、肝功能异常以及免疫抑制剂的应用均是肾移植后糖尿病发生的高危因素,而患者性别则与肾移植后糖尿病的发生无明显相关性。了解肾移植后糖尿病发生的高危因素有助于预防移植后糖尿病的发生,提高肾移植患者的存活率。

BACKGROUND： Diabetes mellitus is one of the main complications after kidney transplantation. Understanding risk factors for diabetes can improve the survival rate of patients undergoing kidney transplantation.OBJECTIVE： To explore the high-risk factors for diabetes mellitus after kidney transplantation.METHODS： A literature search was performed for relevant articles concerning risk factors for diabetes mellitus after kidney transplantation. Literatures that met the study criteria were selected for in-depth data analysis. Fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, liver function, and valley concentration values of other immunosuppressants were measured in patients receiving kidney transplantation, based on which we analyzed whether the occurrence of diabetes mellitus after kidney transplantation is associated with sex, age, body mass index, family history of diabetes, diabetes onset time after kidney transplantation, liver function, and administration of immunosuppressive drugs and hormones.RESULTS AND CONCLUSION： Patients with post-transplantation diabetes exhibited atypical symptoms of diabetes, early onset, islet dysfunction, and abnormal liver function. Age, body mass index, family history of diabetes, impaired glucose tolerance, abnormal liver function, and administration of immunosuppressive drugs are risk factors for diabetes after kidney transplantation, whereas there is no obvious association between gender and diabetes mellitus after kidney transplantation. Understanding risk factors for diabetes mellitus after kidney transplantation contributes to improving the survival rate of patients with renal transplantation.